Surgery of the nasal cavity and paranasal sinuses often results in the mucosal lining of the nasal cavity becoming raw and rough. These surfaces have a tendency to adhere to each other in the immediate postoperative period and form scars. This is of particular concern in the superior portion of the nasal cavity where mucosal surfaces are close to each other. Such adhesions and scars cause postsurgical complications such as decreased air flow and usually require surgical correction.
The most common approach to the prevention of adhesions or scars is to pack the nasal cavity with lubricated gauze strips or other materials such as telfa pads. Surgeons also pack the operative site with hydratable and expandable packing or other materials such as prefabricated tampons. However, these approaches are specifically designed for the control of hemostasis, and not the prevention of scar formation.
One such device is described in U.S. Pat. No. 4,646,739 to Doyle where a sinus pack tampon is used as hemostat for short term packing of the operative site. The tampon is formed of a compressed porous material, such as a dry hydrocellulose, that expands on contact with fluid, to prevent nasal hemorrhaging. The tampon is shaped to conform to the nasal passage and prevent apparition into the nasal fossa.
Another postoperative packing known as "Merocel Sinus-Pak", is formed of an open cell foam of polyvinyl alcohol. This product, however, dries out rapidly and allows tissue to grow into the open cells of the foam.
In addition, such packings tend to displace the middle turbinate causing it to adhere to the nasal septum, with resultant airway obstruction. While various septal splints have been used to prevent adhesions to the nasal septum, adhesions of the lateral side of the middle turbinate or concha to the upper sinus wall are not prevented.
A device designed to prevent adhesions and scar formation between the middle turbinate and lateral nasal wall or septum is described in U.S. Pat. No. 5,094,233 to Brennan, entitled "Turbinate Sheath Device." A septal splint and solid plastic sheath surround the middle turbinate. However, the sheath does not expand to line the mucosal surfaces of the nasal cavity, nor does it apply pressure to the medial and lateral aspects of the nasal cavity for reducing postoperative edema and aid in mucosal healing.
U.S. Pat. No. 4,030,504 to Doyle, entitled "Nasal Hemostat and Methods of Construction of Nasal Hemostat," describes a nasal tampon fabricated from an absorbable, expandable foam to control postoperative bleeding. However, the porous material of the nasal hemostat does not prevent adhesion of the tampon surface to the nasal mucosa. Additionally, the nasal hemostat does not expand to conform to surfaces of the nasal mucosa, nor does it expand into the superior portion of the nasal cavity.